title: Recent pattern of Co-infection amongst HIV seropositive individuals in tertiary care hospital, Kolkata.
abstract: BACKGROUND
  Opportunistic Infections (OIs) and co-infections are the major cause of deaths amongst HIV infected individuals and this mostly depends upon the risk factors, type of exposure and geographic region. The commonest types of infections reported are tuberculosis, chronic diarrhoea, oral candidiasis, herpes simplex virus-2, cytomegalovirus, hepatitis B virus and hepatitis C virus. Due to the scarcity of OIs data available from this region, we had designed a study to determine the frequency of different OIs amongst HIV seropositive patients.
  
  
  METHODS
  Analysis of the different spectrum of OIs/Co-infections were carried out with 204 HIV sero-positive patients (142 males and 62 females) who visited the HIV/AIDS Apex Clinic in a tertiary care hospital from March 2006 to March 2009. The CD4+ count was estimated using FACS Calibur, the routine smear test, serology, nested RT-PCR and DNA sequencing were carried out to determine the different OIs.
  
  
  RESULTS
  In this study, HIV seropositive patients were mostly from middle age group (31-40 yrs) with CD4+ counts in majority of symptomatic AIDS patients below 200 cells/mm3. The common co-infections/opportunistic infections were OC (53.43%), CD (47.05%), HSV-2 (36.76%), TB (35.29%), CMV (26.96%), HBV (15.19%) and HCV (7.35%). Dual infections, like HSV-2 & CMV (15.38%), HSV-2 & TB (14.61%), HSV-2 & oral candidiasis (24.61%) and CMV & oral candidiasis (14.61%) were significant in follow-up patients. Triple infections were also common e.g., TB, CD, OC infection occurring frequently in about 14.21% of the study population. Multiple infections like OC, TB, CD amongst the viral co-infected patients with HSV-2, HCV, CMV and HBV are also reported in this study. The genotyping analysis of the HCV co-infected HIV individuals shows that two belonged to HCV genotype 1 and 8 belonged to genotype 3.
  
  
  CONCLUSIONS
  A wide spectrum of OIs were observed amongst HIV-infected patients in the HIV/AIDS Apex Clinic. Oral candidiasis, CD, CMV and HSV-2, were the common OIs in those patients. This study aims to provide a clearer picture regarding infections occurring amongst HIV seropositive individuals so that the scientific findings could be translated into sustainable prevention programmes and improved public health policies.
  
  
  BACKGROUND
  None.
authors.affiliation: I, C, M, R, Virus Unit, Kolkata, I,D, & B,G, Hospital Campus, GB-4 (East Wing), 1st Floor; 57, Dr, Suresh Chandra Banerjee Road, Beliaghata, Kolkata-700010, India.
authors.forename: Kallol
authors.initials: K
authors.lastname: Saha
authors.forename: Rushna
authors.initials: R
authors.lastname: Firdaus
authors.forename: Poonam
authors.initials: P
authors.lastname: Santra
authors.forename: Jyotirmoy
authors.initials: J
authors.lastname: Pal
authors.forename: Arnab
authors.initials: A
authors.lastname: Roy
authors.forename: Mihir K
authors.initials: MK
authors.lastname: Bhattacharya
authors.forename: Sekhar
authors.initials: S
authors.lastname: Chakrabarti
authors.forename: Provash C
authors.initials: PC
authors.lastname: Sadhukhan
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology / Q000821:virology; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006679:HIV Seropositivity / Q000150:complications*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D014777:Virus Diseases / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology / Q000821:virology; D014780:Viruses / Q000235:genetics / Q000302:isolation & purification; D055815:Young Adult